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What is Advanced Practice?

Advanced Practice (AP) is a level of practice characterised by a high degree of autonomy and complex decision making.  It is designed to transform and modernise pathways of care, enabling the safe and effective sharing of skills across traditional professional boundaries within clinical professions such as nursing, pharmacy, paramedics, and occupational therapy.

Advanced practitioners (APs) are healthcare professionals, educated to Master’s level or equivalent, with the skills and knowledge to allow them to expand their scope of practice to better meet the needs of the people they care for. 

Read more about AP.

A detailed definition of Advanced Practice, its underpinning standards and governance, can be found in the Multi-professional framework for advanced clinical practice in England. The framework ensures there is national consistency in the level of practice across multi-professional roles that is clearly understood by the public, advanced practitioners, their colleagues, education providers and employers.

On 18 April 2023, we held a Q&A webinar. Watch the recording by clicking below.

HEE have put together a handbook with advice for organisations looking to implement Advanced Practice. Please have a read through the handbook, which answers frequently asked questions.

Advanced Practice training pathways

Employers are invited to put forward requests for funding under the training pathways outlined below.
HEE intends, subject to budget signoff, to provide funding as detailed:

Training pathway

Tuition fees (paid by HEE directly to Higher Education Institutions)

Supervision fee (paid to employer via the NCL Training Hub)

 

  1. Advanced Practice Apprenticeship

N/A (paid by the employer through the apprenticeship levy)

£6,000 per annum

  1. Advanced Practice MSc qualification

Full tuition fees for a period of up to 3 years practice

£2,500 per annum

  1. Advanced Practice Portfolio Route: Top-up modules

Tuition fees named modules as agreed between HEE and the employer. Modules must be completed within the academic year and must upskill the individual to fully meet the Multi-Professional ACP Framework

N/A

Pathway 1: Advanced Practice Apprenticeship

Apprenticeships offer structured training with an employer & lead to nationally recognised qualifications.

  • The trainee is an employee and receives a salary throughout the programme. This is paid by the employer.

  • Cost of the programme delivered by the university is £12,000. This can be paid for through the apprenticeship levy.

    • For non-levy paying organisations they can either reserve funds (95% of costs paid with 5% contribution from the employer) or a receive a levy transfer if available (100% of costs paid). The HEE apprenticeship team can support with this process.

  • £6,000 supervision fee - For organisations who utilise the apprenticeship levy for funding of programme fees, HEE’s contribution to workplace supervision will be increased to £6,000. This is available for each new and continuing student undertaking a programme of study in the 2022/23 academic year and will be paid to employers after the named individual student has enrolled.

HEE funding for Advanced Practice programmes is limited and therefore employers are encouraged to utilise apprenticeship programmes where available and consider this training pathway as their primary option.

This will enable support to be provided for an increased number of applicants, and access to a higher supervision fee of £6,000 a year. This supervision fee is available for each new and continuing student undertaking a programme of study in the 2022/23 academic year and will be paid to employers after the named individual student has enrolled. Employers should ensure that individuals put on to an apprenticeship route are committed to completing the full programme.

Eligibility/entry requirements

To be eligible for government funding, at the start of the apprenticeship, apprentices must:

  • Be 16+ years old

  • Not already be in full-time education

  • Have the right to live and work in England*

  • Be one of the following*:

    • a citizen of a country within the European Economic Area (EEA) (including other countries determined within the EEA or those with bilateral agreements), or have the right of abode in the UK, and have been ordinarily resident in the EEA (including other countries determined within the EEA or those with bilateral agreements), for at least the previous three years on the first day of learning;

    • a non-EEA citizen with permission from the UK government to live in the UK, (not for educational purposes) and have been ordinarily resident in the UK for at least the previous three years before the start of learning.

    • *NB For a full list of eligibility criteria including exceptions with regards to refugee visas go to https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1109627/2223_Provider_Rules_Version_2_Final.pdf

As well as meeting the eligibility criteria, applicants will need:

  • To hold a degree from a UK university or equivalent, or, if they are a registered non-graduate practitioner, be able to demonstrate equivalent academic ability and professional experience. Applicants with non-European academic qualifications will need to supply evidence of equivalency through NARIC / ENIC.

  • English and maths functional skills at Level 2 or equivalent. If an apprentice doesn’t hold an English and maths level 2 certificate, they must achieve these qualifications before they can be admitted to the end-point assessment to complete their apprenticeship programme. Find out more about Functional Skills.

  • Current registration with one of the statutory regulators of health and care professions.

  • Employment as a healthcare professional in an appropriate setting on a minimum contract, normally of 30 hours per week.

  • Evidence of their employer’s recommendation for their application for a programme of study leading to an advanced practice role. This will include a formal reference from the employer confirming the applicant:

    • Demonstrates professional values and behaviours

    • Respects people’s diversity, beliefs, culture, needs, values and preferences

    • Shows respect and empathy acting as a role model for others, and

    • Has ‘clinical readiness’ to undertake the programme.

  • Evidence of employer support to undertake the programme, including:

    • The provision of an appropriate mentor to ensure relevant learning in practice

    • The availability of appropriate supervision in clinical practice

    • For the Non-Medical Prescribing (NMP) module, the provision of a Designated Prescribing Practitioner (DPP).

  • Normally a minimum of two years post-qualification experience in the workplace.

  • For the latest information on vaccination requirements for frontline health and social care workers, please check the NHS England website and the Vaccination as a Condition of Deployment: Frequently Asked Questions (FAQ) for Pre-Registration Nursing and Midwifery and Allied Health Profession Students.

Pathway 2: Advanced Practice MSc qualification

The MSc qualification pathway includes the following incentives:

  • University fees paid fully by HEE to the HEI for a period of up to 3 years practice

  • £2,500 supervision fee for organisations who utilise this route

Eligibility criteria

To apply, you will need to:

  • hold a degree in a health-related discipline. Applicants with evidence of equivalent professional development or academic proficiency will be considered. Applicants with non-European academic qualifications will need to supply evidence of equivalency through UK ENIC (formally NARIC).

  • be currently registered with one of the statutory regulators of health and care professions.

  • be employed as a health care professional.

  • provide evidence of your employer’s recommendation for your application for a programme of study leading to an Advanced Practice role, including a formal reference from the employer confirming the applicant demonstrates professional values and behaviours, respecting people’s diversity, beliefs, culture, needs, values and preferences, and shows respect and empathy acting as a role model for others. It should also confirm your ‘clinical readiness’ to undertake the programme.

  • show evidence of employer support to undertake the programme including; the provision of a mentor to ensure appropriate learning in practice; the availability of appropriate supervision in clinical practice; and the provision of a Designated Prescribing Practitioner (DPP) with evidence of a qualification at level 7 during the Non-Medical prescribing module.

  • have relevant post-qualification experience, as specified by the appropriate regulatory body.

How long does it take?

It is expected that most students will complete the qualification in the minimum time of approximately 2.5 years by studying 60 credits a year, but there is flexibility to take up to four years to complete.

Pathway 3: Top-up modules/ ePortfolio route

Only top-up module requests for conversion of HEE-funded PGDip’s to the full MSc will be funded by HEE London.

Any requests for stand-alone modules that could complete established APs’ mapping of capabilities against the domains of the Multi Professional Framework for Advanced Practice would be directed to the national ePortfolio (Supported) Route process to receive recognition by the Centre of Advancing Practice.

Please contact the NCL AP Lead, Daniela Gomes to find out how to apply.

About the ePortfolio Route

The ePortfolio (supported) Route has been specifically designed to enable recognition with the Centre for Advancing Practice of existing, experienced advanced practitioners, who at the time of the expression of interest, are working clinically in advanced practitioner roles on a regular basis, and who have already completed their advanced practice experiential and educational learning mostly before 2017 when HEE’s Multi-professional framework for advanced clinical practice in England was published.

Completing the ePortfolio (supported) Route is voluntary, but Centre for Advancing Practice created the process for recognition of advanced practitioners for quality assurance purposes to ensure a consistent approach to the urgent need to recognise the experience, knowledge, and skills of existing, experienced advanced practitioners in the workforce. The components and processes of the ePortfolio (supported) Route act as an assurance for the Centre that applicants for the Route are experienced advanced practitioners who have demonstrated the development of the capabilities outlined in the Multi-professional framework (2017).

To date, three cohorts of applicants are working through the ePortfolio (supported) Route. The Centre has opened an Expressions of Interest (EOI) form to gauge the level of demand for future cohorts - this is being kept open (there's no deadline to apply) so that practitioners, with support from their organisational advanced practice lead, can submit their EOIs throughout the year. The Centre will then contact the applicant once future Cohorts dates are available. The Centre expects this to be in early 2024.

Any specific questions about the ePortfolio route can be directed to advancedpractice@hee.nhs.uk

Funding/supervision fee

Training pathway

Tuition fees (paid by HEE directly to Higher Education Institutions)

Supervision fee (paid to employer via the NCL Training Hub)

 

AP MSc qualification

Full tuition fees for a period of up to 3 years practice

£2,500 per annum

AP Apprenticeship

N/A (paid by the employer through the apprenticeship levy)

£6,000 per annum

AP Portfolio Route:

Top-up modules

Tuition fees named modules as agreed between HEE and the employer. Modules must be completed within the academic year and must upskill the individual to fully meet the Multi-Professional ACP Framework

N/A

HEE conditions for AP funding

Learners

▪ Funding is provided for programmes of accredited academic study for staff who are already registered as nurses, midwives, pharmacists or AHPs to train as APs.

▪ This is a specific offer to develop the AP workforce. It cannot be replaced by an equivalent offer of funding for other activity.

▪ The AP trainee should be undergoing training in line with the HEE Multi-Professional Advanced Clinical Practice Framework.

▪ For new AP trainees, a full pathway (MSc or apprenticeship) should be undertaken rather than single modules.

▪ Staff supported by this funding must be academically eligible and ready to start a course in the 2022/23 academic year.

Employers

▪ Should be able to articulate a clear case for the AP role, demonstrating that it is an organisational priority in line with their workforce transformation plans and service requirements.

▪ Should, wherever possible, be able to articulate how new AP numbers connect to system level recovery priorities

▪ Should be able to provide assurance that there will be an AP post on completion of training. This is necessary to avoid investing in the upskilling of staff who cannot then put their advanced skills into practice.

▪ Must identify an appropriately trained supervisor who will be able to apply the Principles of the Workplace Supervision for Advanced Practice Framework and the Minimum Expected Standards of Supervision.

▪ The expectation is that AP trainees will have supervision over the course of their training adhering to the principles of the HEE Quality Framework, Multi-Professional Advanced Clinical Practice Framework and The Minimum Expected Standards for Supervision for all learners. This should include provision of a suitable workplace-based learning environment and opportunities to gain competence across the 4 pillars of advanced practice (clinical practice, leadership/management, research, and education).

▪ Provide sufficient study leave for university training. It should not be expected that AP trainees take unpaid or annual leave for dedicated training days.

▪ Encourage trainees to complete HEE’s National Education and Training Survey (NETS)

▪ Ensure that the supervision funding reporting form 2022/23 is fully completed and returned to HEE (this will be sent later in the year).

Where these conditions are not met, funding may be discontinued. In the unlikely event of recurrent failures to provide AP trainees with appropriate support, future ACP funding may be fully withdrawn from the employer.

Applying for Advanced Practice

We are now accepting Expressions of Interest from employers throughout the year. Your application should be timed to allow for approximately 60 days before the deadline to apply to your chosen HEI.

How to prepare?
  • Supporting an employee to apply for AP training should be a strategic decision, informed by extensive planning, preparation and a state of readiness.

  • HEE designed dedicated checklists for AP candidates, employers and workplace supervisors to enable both the organisation- and individual-level readiness to apply.

  • You should also consult the Extra resources tab (below) for links to HEE films and podcasts that can help with preparing.

For ACP candidates

If you are aspiring to be an advanced practitioner or are already in post and applying for funding to complete your advanced practice MSc, it is important to understand the expectations and commitment needed to train for this role.

The following checklist is for aspiring and trainee advanced practitioners to self-assess their readiness for advanced practice training.

For Employers

Trainees on ACP pathways require regular educational and workplace supervision, opportunities for work-based learning across the four pillars of advanced practice and adequate study leave throughout their educational programmes.

Workforce planning is essential to ensuring the success of ACP training and reduce the risks of individuals withdrawing from programmes and workforce attrition. In order to support organisations with their workforce planning, HEE have developed the Readiness Checklist to assist you in considering the infrastructure needed to fully support AP trainees.

For AP Supervisors

Supervision is an essential element of training to be an advanced practitioner. If you have been asked to supervise a trainee advanced practitioner, it is important to ensure you have the experience, knowledge, and expertise to provide good quality supervision. Use the Supervisor readiness checklist to self-audit:

For support with preparing your organisation for AP, contact the centralised NCL ACP inbox.

How to apply?

How to apply

Please follow the steps below to apply:

  1. AP Expression of Interest form - to be completed online by the employer

  1. The 'Readiness to become an Advanced Practitioner' checklist - to be completed by the individual clinician/learner being put forward for the ACP, in close collaboration with their employer.

  1. The Primary Care Employer Readiness Checklist - to be completed by the employer
    NB Evidence of every criterion being met, is not necessary, with the exception of confirming the organisation has:

    • an executive sponsor for ACP,

    • a named supervisor

    • an AP role at the completion of training. 

  1. The 'Supervisor readiness' checklist - to be completed by the employer and the nominated supervisor

  2. Once you've submitted the EOI online, email a copy of the three documents above (step 2,3,4) to the centralised NCL ACP inbox.

  3. All EOIs will be reviewed by the NCL AP Lead to quality assure that the application meets the HEE requirements. Once approved, an EOI will be centrally submitted to HEE by the NCL Training Hub.

  4. Applicants will be contacted about the result of the review/next steps via email.


These steps reflect the HEE's ACP process flowchart for providers.

To find out more about the application process, contact Daniela Gomes, NCL AP Lead at the centralised NCL ACP inbox.

Additional Incentivised AP offers

There are additionally incentivised offers available for 23-24 cohorts in the following specialities:

Health Education England Advanced Practice in Cancer and Imaging Workforce

In the 23-24 academic year HEE Centre for Advancing Practice and HEE National Cancer and Diagnostic programme are collaborating to provide an incentivised funding offer to NHS providers in all HEE regions.

The offer is aimed at supporting the development, co-ordination and leadership of advanced practice trainees and their educational supervision provision in line with the Multi-professional framework for advanced practice in England.

Health Education England Advanced Critical Care Practitioner Workforce

Health Education England (HEE) Centre for Advancing Practice and HEE National Critical Care programme are collaborating to provide this incentivised funding offer to NHS providers in all HEE regions. This offer is aimed development, co-ordination and leadership of advanced critical care practitioner trainees and their educational supervision provision in line with the Multi-professional framework for advanced practice in England.

Please note that all applications for HEE funded places are required to meet the essential criteria as outlined in the handbook and, is subject to budgetary sign off in April 2023.

More on AP supervision

Workplace supervision

Workplace Supervision for Advanced Clinical Practice - Advanced Practice (hee.nhs.uk) - the publication sets out seven fundamental considerations which underpin supervision in advanced practice. It also draws on these fundamentals to describe what is required to:

  • establish the requirements of multi-professional advanced practitioner supervision

  • establish the training and development of supervisors

  • improve consistency and limit supervision practice variation across the health and care sector through a combination of a Coordinating Education Supervisor and Associate Supervisors matched to specialty knowledge and skills development.

  • ensure supervision with a focus on professional and public safety in advanced clinical practice. 

Minimum standards for supervision

The following guidance is for supervisors, managers, employers, and trainee advanced practitioners to advise of the Health Education England Centre for Advancing Practice minimum expected standards for supervision.

Community of Practice - Adult Mental Health

Older Adult Mental Health

There is a new National Virtual Community of Practice for Trainee and Qualified APs working in older Adult Mental Health (still relevant for those working in e.g Frailty/Care homes etc that will see a lot of Mental Health issues).

This occurs every last Wednesday of the month from 12:30 to 13:30.

Those wishing to attend need to email jodie.ley@nhs.net for an invitation

Advanced Nurse Practitioner Virtual Drop-In Sessions - hosted by the Professional Nurse Advocates

Are you an Advanced Nurse Practitioner working in NCL ?

Here's an opportunity to meet other ANP’s across NCL. This space will give you the chance you to:

  • Build your network

  • Celebrate success

  • Reflect on challenges

  • Share experiences and learning

Join our Professional Nurse Advocate team via MS Teams: Every last Tuesday of the month 12:30-13:30

Extra resources
  • Listen to HEE's Advanced Practice Weekly Podcast- A podcast on Anchor

  • Watch a series of films talking through the ACP role, the vision, service development and workforce planning across the health and care system as well as one-to-one interviews with ACPs in practice or training.

Invoicing for supervision fee

To draw down funding for your ACP trainees please submit your invoice to nclicb.thfinance@nhs.net naming the trainee, their host practice, date when they started the programme and when they're due to complete, and the academic year covered by the invoice.

With any questions, contact Maria Powazka, Programme Manager, NCL TH.

NEW: Advanced Practitioners and ARRS

On 6th March 2023, Changes to the GP Contract in 2023/24, flagged the following updates to the ARRS funding rules:

  • PCNs can now be reimbursed for the time that First Contact Practitioners spend out of practice undertaking education and training to become Advanced Practitioners.

  • Advanced Clinical Practitioner Nurses are now eligible for reimbursement under ARRS as Advanced Practitioners.